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Kernberg

and Modern Object Relations


Theory
Richard D. Chessick, M.D.

e-Book 2015 International Psychotherapy Institute


from Psychology of the Self and the Treatment of Narcissism Richard D. Chessick, M.D.
Copyright 1985 Richard D. Chessick, M.D.

All Rights Reserved


Created in the United States of America

Table of Contents
Kernbergs Criticism of Klein
Views of Modell
Problems in Object Relations Theory
Self in Object Relations Theory
Kernbergs Developmental Stages
Kernberg on the Superego
Other Clinical Points
Criticism of Kernberg
References

Kernberg and Modern Object Relations Theory


Kernbergs Criticism of Klein
Kernberg (1972, 1980) makes a number of critical comments
about the work of Melanie Klein. He points out that Kleins technique,
in which fantasies are collected from children aged 2 or 3, contains
nothing to justify her assumptions about the fantasy life of the 1-year
old. There is no evidence for assumed innate knowledge, for example
of sexuality, genitals, or inborn oedipal strivings, or for the death
instinct.
Kernberg maintains that higher levels of defenses are neglected
by the Kleinians and that the distinction between the normal and the
pathological in the infant is blurred. Kleins terminology, he explains,
hopelessly confuses mechanisms, structures, and fantasies. For
example, what is an internal object? Also, there is in Klein little
distinction between diagnoses or in the treatment of various types of
adult pathology.
Kernberg observes that the Kleinian emphasis on early object
relations and projection leads in treatment to early deep magical

Psychology of the Self and the Treatment of Narcissism

transference interpretations, assumed to be critical for the cure but


which he fears actually may set off further regression. The Kleinians,
he says, neglect the therapeutic alliance and blur the distinction
between the transference and the transference neurosis. They violate
the well-known rule of interpreting resistance before content and of
working in from the surface.
Kernberg, in an argument that he will later (1974, 1974a) apply
to Kohut, believes that there is no evidence that fantasies emerging in
the transference repeat actual fantasies occurring in the first year of
life. He objects to the Kleinian equation of introjection and
identification, but he agrees with the Kleinians on the importance of
early superego precursors. Still, the mad language of Kleinian
analysts, quickly concentrating on breasts, milk, and so on,
overemphasizes these confused concepts at the expense of everything
else, says Kernberg, and leads to an intellectual indoctrination with the
same interpretations being made over and over again. This criticism
was already made by Balint (1968).
As a case example, Kernberg (1972) refers to a treatment
reported by the Kleinian analyst Segal of a candidate-analysand who

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started the first session by saying that he was determined to be


qualified in the minimum time and then spoke about his digestive
troubles and, in another context, about cows. The analyst interpreted
that I was the cow, like the mother who breast-fed him, and that he
felt that he was going to empty me greedily, as fast as possible, of all
my analysis-milk; this interpretation immediately brought out
material about his guilt in relation to exhausting and exploiting his
mother (p. 87). Kernberg wonders to what extent this eager patientcandidate would accept such a deep interpretation as part of his wish
to learn a new magical language, and to what extent such learning
would feed into defenses of intellectualization and rationalization. His
main point is that the patients greediness might also reflect a
narcissistic character structure, and the extent to which such character
defenses might later interfere with the deepening of the transference
should be clarified by exploring that defensive structure further,
rather than by gratifying the patients eagerness with a direct
interpretation of the possible ultimate source of the trait (p. 87).
In further criticisms Kernberg states that stress on such concepts
as constitutional envy and the death instinct represent a form of
pseudo-biology. There is no clarity in the Kleinian notion of positions

Psychology of the Self and the Treatment of Narcissism

about how they are related to or different from the classical


defenses. These complaints, along with Gills (1982) comment that
despite statements to the contrary, the Kleinians do seem to make
inappropriately deep transference interpretations which fail to make
adequate contact with the current reality of the actual analytic
situation (p. 136) are rejected by Sandler and Sandler, and by Steiner
(Bornstein 1984, pp. 391-392, p. 446). These authors point out that
Kleinians differ considerably in their acceptance of Melanie Kleins
doctrines just as Freudians differ, and that many modern Kleinians
perhaps the majorityare sensitive and do not engage in premature
deep interpretations.
Finally, Kernberg criticizes the Kleinian use of splitting, which is
sometimes equated with repression and sometimes with a more
primitive operation, and projective identification, which is a hybrid for
the Kleinians of an internal psychic mechanism combined with an
interpersonal attempt at control and communication.
Kernberg (1975, pp. 30-31) redefines projective identification as
projection that has not succeeded entirely due to a weak ego, so that
patients continue to experience their own aggression as well as fearing

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it from the external object. Patients, therefore, fear the external object
and must control or even attack and destroy it before it destroys them.
Abend et al. (1983) point out that every author defines this term
differently and it just leads to confusion.

Views of Modell
Many psychoanalysts feel that it is more realistic and practical in
working with narcissistic and borderline patients to turn from the
Kleinians to Modells technique of allowing a transitional object
transference to take place so that the development of the patient can
resume; here we have a type of archaic transference (Gedo 1984). The
notion of transitional object was first introduced by Winnicott and
later referred to by Modell (1963, 1968). He defines a transitional
object phase of the development of object love, during which there is
a clinging dependent relationship to the external object, which is given
magical powers to produce well-being and protection. For Modell, this
stands between primary narcissism, where there is no recognition of
the object as separate, and true object love, where there is the capacity
to relate to the object as separate, human, and having needs of its own.

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Modell emphasizes that treatment should provide a good-enough


holding environment that leads to a transitional object transference, a
primitive form of object relationship in the transference, which is
closer to schizophrenia than neuroses. In this transference mere
contact with the therapist is expected to passively cure and afford
magical protection; the patient does not expect to do any actual work
in the treatment. By emphasizing the transitional object transference,
Modell argues that he is distinguishing among the classical type of
psychoneuroses where other typical transferences appear, the
narcissistic patientwho attempts to maintain an illusion of selfsufficiency in a closed system and thus does not form a transitional
object transference, and the borderline patient who shows this
intense object hunger. Such archaic transferences as described by
Little (1981) and others are life-and-death types of transferences and
therapist becomes an oxygen line to keep the patient alive.
This is a descriptive picture but is meta-psychologically confused.
It blurs the distinction between borderline personality disorders and
schizophrenia and it ignores the difference between the object and
the aggregate of object representations. It does, however, call
attention to the idea of healing as facilitated by the analytic setting

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serving as a holding environment. Winnicott (1958) called attention to


the gratification implicit in the constancy and reliability of the
analysts judgment, the analysts capacity to perceive the patients
unique identity, and the constancy and reliability of the person of the
analyst.
Throughout the discussion and cutting across all the theories,
there is a dilemma in that there are two basic psychoanalytic models
of treatment and cure. The first stresses a neutral-interpretive stance
of the analyst; the second stresses more the nurturing-reconstructive
experience within the analytic interaction. Thus Kernberg and many
traditional psychoanalysts in the United States are clinicians of the
first approach, while Balint, Winnicott, and Kohut stress the allowing
of regression to traumatic developmental phases and the resumption
of growth via the analytic relationship.
The dilemma to which we will repeatedly return in this book is
whether the neutral-interpretive stance when it is predominant
generates overwhelming resistances due to the arid interpersonal
ambience. Or, does the nurturing-reconstructive experience when it is
emphasized at the expense of neutrality and interpretation really

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allow the patient to experience the beneficial aspects of the


relationship without first analyzing the rigid stereotyped self and
object images? Volkan
writes, It is only when the therapist is differentiated from the
archaic image that the patients introjection of and identification with
the therapists function is seen as operating in the service of altering
structures already formed and/or forming new ones (p. 87).

Problems in Object Relations Theory


The basic assumption of object relations theory is stated by
Shapiro (1978):
One can understand the relationships between people
through an examination of the internal images they have of
one another. In the healthiest people, these images
correspond rather accurately to the reality of the other
person and are continually reshaped and reworked as new
information is perceived and integrated. In less
psychologically healthy people, the images are stereotyped,
rigid, and relatively unchanged by new information, (p.
1309)

Object relations theory is useful in understanding the puzzling

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lack of influence of the benevolent therapist, that is to say, why a


corrective emotional experience, if it does occur in psychotherapy,
occurs slowly at times, often to the agonizing countertransference
frustration of the well-intentioned therapist. However, object relations
theory tends to lend itself to medieval scholastics and obsessional
disputes about postulated theoretical details, but it has also shown
value in organizing direct observations of the preoedipal mother-child
unit (Mahler et al. 1975).
There are many debatable problems inherent in object relations
theory. No methodology has been developed to verify those
reconstructions of object relations theorywhich have been derived
from adult treatmentof the various phases of development as
described by Kernberg (Abend et al. 1983). Nor has an approach been
devised that enables us to correlate these reconstructions with the
data of direct observation of the preoedipal mother-child unit without
the injection of preconceived notions of the observer.
Authors disagree about primitive internalized object relations.
Are these a source of motivation and the only or primary source or an
additional explanation for behaviors insufficiently explained by drive

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theories? Neither of these views make clear what causes these


internalizations to affect behavior; the relationship between drives
and internalizations is not clear. Gedo (1979) points out that the
rejection of the death instinct by most analysts leaves that body of
clinical data classifiable under the rubric of repetition compulsion
without motivational underpinnings. In my judgment, the conception
of early object relations as an additional source of human motivation
was one major tendency to fill this metapsychological void (p. 366).
In addition, the problem of internalization is complex. Schafer
(1968) defines internalization as all those processes by which a
subject transforms real or imagined regulatory interactions with the
environment into inner regulations and characteristics. Perception is
not the same thing as internalization and the cognitive creation of
object representations is not the same as internalization.
Internalization is structural; perception and cognitive creation are
experiential. The relationship between the structural and the
experiential remains unclear in these theories, and the path from the
experiential to the structural represents a big problem and already
assumes a certain ego capacity. Thus the intrapsychic movement from
perceptions to object representations to introjects as internal foreign

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presences to psychic structure is characterized differently by different


object relations theorists.
The authors in this group do not always distinguish between
interpersonal relations, which Meissner (1978, 1980a) calls object
relatedness, i.e., real observable interactions between people, and
object relations, which are experiences of either party from within the
interaction and their internal experiences of it.
Another confusion pertains to the relationship between object
representation and introject. According to Volkan (1976), Kernberg
and Jacobson avoid the term introject entirely, whereas Giovacchini
regards it as identical to an object representation. Each author uses
these terms differently.
Volkan offers a definition derived from his studies of the
mourning process. He defines an introject as, a special, already
differentiated, object representation that strives for absorption into
the self-representation in order to achieve identification (p. 59).
Introjects, in contrast to object representations, are functional and
may play a role in the formation and alteration of psychic structure

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(p. 59). I will discuss and clarify this matter. For Volkan, an introject is
experienced as an inner presence because it is between being an object
representation and not yet having been absorbed into the psychic ego
structure. Therapy for him, as for Giovacchini, leans heavily on
absorbing the introject of the analyst into the psychic structure in
order to alter or reform the psychic structure by, for example,
replacement or attenuation of early malevolent introjects.
The mechanisms of internalization are very often confused in the
literature. Identification is the most mature, less directly dependent on
the drives, most adaptively selective, least ambivalent, more a
modeling process, and originally a modeling on the parents. It is an
automatic, usually unconscious mental process whereby an individual
becomes like another person in one or several aspects. It is part of the
learning process but also a means of adaptation to a feared or lost
object. Identification is growth promoting and leads to better
adaptationa critical clinical point.
The word introjection was used by Freud in two ways. Originally
(1917) he used it in Morning and Melancholia to mean a lost object
taken in and retained ag part of the psychic structure. Later (Freud

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1933) it represented taking in the parents demands as if they were


ones own in the formation of the superego. Here one does not simply
copy the object selectively, as in identification; a more encompassing
process occurs. Freuds original definitions assumed a solid repression
barrier with a cohesive sense of self and a relatively well functioning
ego. Thus it has the flavor of a higher level in Freuds usage.
Incorporation is a form or model of introjection or taking into the
mind the attributes of another person that involves the fantasy of oral
ingestion

and

swallowing.

Identification

accomplished

by

incorporation implies change by fantasied cannibalism; I am


devouring your book like a hungry wolf, as a patient told me once.
Incorporation is a primitive kind of interpersonal relations fantasy. It
is primary process ideation, a form of fantasied object-relatedness.
At one time it was thought that this fantasy accompanies all
introjection, but this is not now believed to be correct.
Schafer (1968) offers a modern review of introjection, which he
defines as a process through which object representations are
constituted as introjects or are changed into them. An introject is an
inner presence with which one feels in continuous or intermittent

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dynamic relationship, says Schafer, and he lists certain characteristics


of introjects which have great clinical value:
1. They may be conceived of as a person-like thing or creature.
2. They may be unconscious, preconscious, or conscious.
3. They may be experienced as exerting a pressure or influence
on the subjects state or behavior independently of
conscious efforts to control it.
4. They do not copy external objects since they are shaped by
fantasies,
projections,
symbolizations,
misunderstandings, idealizations, depreciations, and
selective biases originating in the subjects past history
and present developmental phase and dynamic
position (p. 73).
5. Once formed, an introject diminishes the influence of the
external object. This is a key point. An introject is
formed due to severe ambivalence or more or less
disappointment in an attempt to modify distressing
relations with the external object.
6. Once formed, the introject alters a relationship with an
external object in a way not correctable by further
experiences with the external object since the influence
of the external object is now diminished.

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7. Introjection is an event, a change in psychic organization and


in the psychic status of an object representation. Notice
how this assumes an active role in the ego of the infant.
It is necessary to understand these descriptions of introjects and
introjection in order to compare them with Kohuts notion of
transmuting internalization that will be presented in Chapter 8.
Introjection represents or expresses a regressive modification of the
boundaries and the reality testing function of the ego. It perpetuates
neediness and ambivalence, displacing it to the inside. In contrast to
transmuting internalization, introjections are not growth promoting
but represent a passive mode of mastery and are not adaptive per se.
Splitting is a term used differently by authors in object relations
theory (Pruyser 1975). It generally represents a failure in the
synthesizing function of the ego which Freud (1940) related to
disavowal, but which has come to have many more preoedipal
connotations. It is crucial to the turning away from reality in any
condition, including dreams, perversions, neuroses, and psychoses,
and it enables these processes to occur.
Projection is defined by the later object relations theorists as a

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process in which object representations and self-representations


charged with energy or influence (that is to say, made into introjects),
are experienced as coming from outside the boundaries of the self,
such as from the analyst, and ascribed to an independent object,
creature, or thing (e.g., the influencing machine). It leads to a
separation from the unacceptable in contrast to projective
identification as defined above, which actively continues a
relationship.

Self in Object Relations Theory


Kernberg (1982) proposes eliminating the concept of self as
opposed to object because he argues that used in this way it is a
psychosocial description. For Kernberg the self as a psychic structure
originates from both libidinally and aggressively invested selfrepresentations: It is, in short, an ego function and structure that
evolves gradually from the integration of its component selfrepresentations into a supraordinate structure that incorporates other
ego functions (p. 905). Thus, an aggregate of such selfrepresentations exists in the psyche, with various degrees of internal
contradiction and disjointedness or integration from the autistic to the

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realistic; the final set of self-representations is a function of how well


integrated and developed these earlier representations have become.
The same is true for object representations.
For any adaptively successful behavior there has to be a
relatively well-organized, well-developed, and well-integrated set of
self and object representations in the individual. Self and object
representations are essentially subjective conceptualizations or
experiential guide-posts that lead to behavior for many modern object
relations theorists, whereas an introject is thought of as exerting an
influence on a persons thoughts or behavior whether the person likes
it or not; unfortunately in the literature this distinction is often
blurred. Greenberg and Mitchell (1983) claim that Kernberg, although
he follows Hartmann in defining the self as a representation, switches
to referring to the self as a structure (p. 335).
Before Kernberg, Jacobson (1964) reached the high point of
complexity in the use of the vicissitudes of self- and objectrepresentations to move toward understanding narcissism. She gave
the definition of healthy narcissism as the libidinal investment of the
self, but then described self-esteem as a more complex phenomenon

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(Teicholz 1978). Any factor disturbing self-esteem contributes to a


disturbance of narcissism, such as split, unstable, or unrealistically
worthless or grandiose self-representations, or:
if the perceptual faculties or the judgment capacity of the
ego is faulty, if the ego ideal retains too much of the
primitive idealizations of self and object, if the critical
powers of the superego are too harsh and unmitigated by a
mature ego and if the superego is unable to regulate the
libidinal and aggressive investment of the self, if the
aggressive or the libidinal drives are insufficiently
neutralized or if they are inadequately fused. (Teicholz
1978, p. 848)

A review of Jacobsons position by Teicholz (1978) demonstrates


the scholastic complexity of Jacobsons object relations theory. As
Greenberg and Mitchell (1983) put it, Hairs are split and resplit until
the flow of Jacobsons argument almost disappears (p. 306).
Kernbergs theorywhich admittedly rests heavily on the work
of Jacobsonis a theory of normal and pathological internal object
relations. His argument concerns itself little with object relatedness or
relationships; instead it focuses on the internalized derivatives of
experienced object relatedness or relationships, which Kernberg

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designates internalized object relationships. Meissner (1978) points


out that the latter seem to come much closer to what has been
described in other contexts as introjects (p. 587). Rather than a
theory of object relatedness it is a theory of object representations,
addressing itself to the vicissitudes and metabolismyet see
Kernbergs objections to Kleins pseudo-biology mentioned aboveof
such internalized object relationships, or internalized objects, or
introjects, with little attention to the relationships with objects as
such. Meissner (1978) continues, Consequently, its risk lies in its
reductionistic tendency to read the development of later and more
differentiated pathology in terms of the primitive vicissitudes of object
relatedness (p. 588).

Kernbergs Developmental Stages


Kernberg (1976) now postulates five stages of the development
of internalized object relations. His first or primary undifferentiated
stage resembles the phase of normal autism of Mahler. Object
relations theory lends itself well to the organization of direct
observations of the initial preoedipal mother-infant dyad, during
which there are no self-or object-representations, or images, as they

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are alternatively called by Kernberg. This stage lasts about a month or


two and leads to the second stage, which corresponds to the symbiotic
phase of Mahler between the age of 2 and 6 months, added to her first
or differentiation sub phase of separation-individuation from 6 to 8
or 9 months of age.
In this stage, there are representations, but these are roughly
undifferentiated self- and-object constellations separated only into
good and bad, and consequently there is in this stage no differentiation
between self and object. Kernberg here postulates a primary
undifferentiated good self-object representation or constellation
associated with pleasurable experiences (pure pleasure ego) and
invested with libido; and a primary undifferentiated bad self-object
representation associated with pain and frustration, and invested
with aggression. Kernbergs conception of self-object-affect unit
should not be confused with Kohuts self-object, which is an
experience-near conception coming from an entirely different
methodology and theory to be described in Section II.
The third stage, which follows the first rumblings of separationindividuation that occurred during the age of 6-9 months, begins when

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the self- and object-representations have been differentiated within


the two primary constellations (good and bad) that predominate in
the second stage described above. It ends, as does the phase of
separation-individuation of Mahler, somewhere in the third year of
life, with the eventual integration of good and bad selfrepresentations into an integrated self-concept and the integration of
good and bad object-representations into total objectrepresentations. The achievement of object constancy and the firm
capacity to distinguish the inner from the outer worldstable ego
boundariesdepends on this stage.
Kernberg (1976) postulates that pathological fixation and/or
regression to this stage of development of internalized object relations
determines borderline personality organization (p. 65). He explains
that in this third stage, the separation of libidinally invested and
aggressively invested self- and object-representations becomes
strengthened by active utilization of the mechanism of splitting, which
is geared to protect the ideal, good relationship with the mother from
contamination by bad self-representations and bad representations
of her (p. 67). Normally this splitting decreases, but Kernberg
continues with a statement meant to specifically delineate the

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intrapsychic pathology that predominates in the borderline


personality: The main objective of the defensive constellation
centering on splitting in the borderline personality organization is to
keep separate the aggressively determined and the libidinally
determined intrapsychic structures stemming from early object
relations (p. 67). Although by the end of the third stage in normal
development there is a firm self-concept differentiated from object
representations, within the self-concept there is still some splitting of
good and bad self-representations. Similarly, within the object
representations at first only representing mother, and then also
father, siblings, etc. (pp. 66-67), good and bad object representations
coexist by splitting which, however, is gradually diminishing.
The fourth stage, beginning in the latter part of the third year of
life and lasting through the oedipal period is characterized by the
integration of libidinally invested and aggressively invested selfrepresentations into the definite self-system, and of libidinally
invested and aggressively invested object-images into total objectrepresentations (p. 67). In this phase the ego and superego as
intrapsychic structures are consolidated. The typical pathology in
this stage is represented by the neuroses and the organization of

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character pathology Kernberg calls higher level, where pathogenic


conflicts typically occur between the ego and a relatively wellintegrated but excessively strict and punitive superego (p. 67).
One variant of character pathology forming at this stage is the
narcissistic personality, which is, according to Kernberg, an abnormal
consolidation, characterized by the formation of a pathological
grandiose self, embedded in a defensive organization similar to that
of the borderline personality organization (p. 68), due to regression
back to the third stage.
Thus, according to Kernberg, the coalescence of the good and
bad self-representations into a definite, integrated, relatively
realistic overall self-representation in the ego, and the coalescence of
the good and bad object representations into definite, integrated,
relatively realistic overall object representations in the ego, is the task
of the fourth stage, and fails in the borderline patient. This failure may
be due to congenital ego defect or excessive aggression fixing the
patient in the third stage or causing regression back to it, and making
the fourth stage, coalescence or integration, impossible. This
coalescence is related to and based on Hartmanns concept of

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neutralization, freeing energy for ego functioning and the higher level
exercise of repression, that is, setting up countercathexes; if it fails, the
weakened ego must utilize splitting as its principal defense, setting in
motion a downward spiral of further weakness and more splitting.
The fifth and final developmental stage, from age 5 to 7, is the
resolution of the oedipal phase, the consolidation of the superego, a
diminished sharp opposition between the ego and the superego
leading to more internal harmony, and finally the formation and
consolidation of ego identity. Notice that in normal development,
according to Kernberg, splitting begins around the third month, peaks
several months later, and gradually disappears at the end of the
second year and beginning of the third year of life, after which there is
the development of repression and higher level defenses (p. 69).

Kernberg on the Superego


In his conceptions of the superego and narcissism, Kernberg
shifts from these more Kleinian concepts to a heavier reliance on the
work of Jacobson. However, Jacobson avoided rigid stepwise
descriptions and considered parental interaction with the child of

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crucial importance rather than those conflicts which go on between


primitive introjects (Abend et al. 1983, p. 163).
The main components of the superego are built up during the
second to fifth year, earlier than Freud thought according to Kernberg.
They are integrated in the fourth to the sixth years and toned down
and consolidated (depersonified and abstracted) during the fifth
through seventh years. The earliest superego structure is from the
internalization of fantastically hostile, highly unrealistic object-images
reflecting expelled, projected, and re-introjected bad self-object
representations (p. 71). (Do not confuse this with Kohuts selfobject.) The stronger the pregenital frustration and constitutional
aggression, the more predominant are these sadistic superego
forerunners; the sadistic superego peaks at the beginning of the fourth
stage of development.
There is also a second primitive superego structurethe
condensed, magical, ideal, all good self- and object-representations
which form the kernel of the ego-ideal through primitive
idealization.

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In the fourth stage of development these two aspects of the


precursors of the superego are integrated, leading to decreased
defensive projection and permitting the internalization of more
realistic demands and prohibitions of the parents during the oedipal
period. Integration and internalization perform the function of toning
down the superego from primitive and archaic to more modulated
and reasonable functioning. In the fifth stage of development the
toned-down superego becomes more integrated and harmonious with
the ego, leading to consolidation of ego identity and the superego
becomes more abstract and depersonified.
Thus in Kernbergs theory two types of superego failure can
occur. In the first type there is a failure in the integration of the
sadistic precursors of the superego with the benign or primitively
idealized precursors which interferes with the internalization of more
realistic oedipal parental images and so perpetuates the primitive
sadistic superego forerunners and fosters excessive reprojection,
leading to paranoia.
In the second type, as in the borderline personality, there is a
similar type of failure of integration of these precursors due to a

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dangerous primitive idealization. External objects are seen as totally


good in order to be sure they cannot be destroyed by projected bad
objects. This phenomenon occurs too early and in too extreme a
fashion due to the need to defend against so much aggression. Thus,
again, idealization is seen as a defense against aggression.
Furthermore, the internalization of primitively idealized early objectimages creates impossible internalized demands, leading to an
impasse in which a catastrophic fusion between these unrealistic
ideal objects and the external persecutors or projected bad objects
then forms. This leads to a sadistic superego nucleus which is
perpetuated by reprojection and re-introjection. It leads to an
interference with the toning down of the superego by the
internalization of more realistic parental prohibitions, with the
integration of the superego itself, and with the development of
harmony between the superego and the ego. The latter causes
interference with the formation of ego identity, leading to the lack of a
consistent solid integrated self-concept, one of the important DSM-III
characteristics of the borderline patient.

Other Clinical Points

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Kernberg distinguishes between the psychotic patient who


presents fusion experiences with the therapist and the borderline
patient who largely maintains reality testing. He claims (1980) that his
object relations theory is an integral part of ego psychology but offers
a theory of affects and motivation which is quite different from
psychoanalytic drive psychology and which (Greenberg and Mitchell
1983) changes from chapter to chapter (p. 331).
For Kernberg, constitutionally determined pleasurable and unpleasurable subjective states that first arise in the undifferentiated
psychophysiological self are integrated and differentiated in the
context of internalized good and bad object relations and are
critical in the differentiation of instinctual drives into libido and
aggression. All three systems in the structural theory of Freud (id, ego,
superego) originate from internalized object relations, according to
Kernberg.
In this theory there is no such thing as primary narcissism (or
primary masochism), and the earliest libidinal investment is in the
undifferentiated self-object representation. (This should not be
confused with Kohuts self-object!) Kernberg (1980) states that

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drives are overall motivational systems that stem from the hierarchy
of libidinal and aggressive constellations. We begin with inborn affect
dispositions which are integrated as good and bad affect states
into self- and object-relations and lead to an overall hierarchical
organization of drive systems, or libido and aggression in the broadest
sense (p. 108).
Kernberg (1980) separates a small group of what he calls
schizoid borderlines who relate to the differentiation sub phase of
separation-individuation and require holding. The remainder of
borderline patients are to be treated by the interpretation of their
projection of all bad and all good self- and object-representations
onto the therapist. He disagrees with Masterson (1976), whom he
insists simplistically ignores the Oedipus complex and its distortions
in borderline patients. Kernberg points out that condensations of
oedipal and pre-oedipal issues must always be taken into
consideration.
Kernberg emphasizes that supportive and interpretive
techniques in intensive psychotherapy tend to cancel each other out,
because two kinds of psychotherapy simultaneously presented to the

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33

patient activate splitting and projection. The basic assumption for the
intensive psychotherapy of most borderline and narcissistic patients is
that the interpretation of split off transference projections leads to
better integration and the eventual development of normal
transferences and more realistic object relations, which then allow the
formal working through of the oedipal phase of development.
Kernberg hopes to combine the therapeutic effort to cognitively
understand and make interpretations to these patients with a holding
function or the authentic concern of the therapist. This authentic
concern manifests itself by respecting the autonomy of the patient,
surviving the patients aggression, and being available for empathy
and support but not abandoning neutrality; Kernberg feels that a
certain balance is needed in managing the archaic transferences which
tend to develop in borderline patients.
In contrast to Kohut, Kernberg believes that the defenses
characteristic of the narcissistic personality disorder are similar to
those of the borderline personality disorder. There is the same
predominance of splitting, denial, projective identification, primitive
idealization, and a sense of omnipotence, based on the same intense

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34

oral aggression as in borderline patients. However, the formation of


the pathological grandiose self in the narcissistic personality by
masking archaic aggression allows better superficial social and work
functioning. Over a long period of time, says Kernberg (1975), we
observe a lack of depth in such people that he calls the emptiness
behind the glitter (p. 230). The basic divergence between the views of
Kernberg and Kohut will be discussed in Chapter 11.
This grandiose self, for Kernberg (1976, 1980), is a defensive
structure which is pathological and must be broken down, and
represents the pathological fusion of the self-image with (a) the
specialness in the reality of the childs early experiences; (b) the
idealized self-imagewhich represents a compensatory glorious selfimage; and (c) the idealized object-image, which is also compensatory
and involves the fantasy of having the ever-loving and ever-giving
parent. These fuse to form a pathological grandiose self that functions
to avoid dependency, and to protect against anticipated attacks from
external objects which have been devalued. External objects are
invested with high and dangerous powers due to projection and so the
world seems as hateful and revengeful as the patient. The patient must
devalue these dangerous others, including the real parents, a

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35

devaluation which is then rationalized as disappointment in


everybody.

Criticism of Kernberg
Heimann (1966) argues that Kernbergs notion of splitting
represents a regressive ego function and not a typical or normal
infantile position. Holzman (1976) attacks Kernbergs gratuitous
assumptions and his complex terminology and assertions, which
unnecessarily complicate his ideas and are unclear. He concludes that
the person of Kernbergs theory does not thinkthat person lives by
introjects.
Calef and Weinshel (1979) argue that Kernbergs fundamental
assumptions have not been made clear. They ask what criteria justify
his selective borrowing from the work of Melanie Klein. These authors
question the source of his clinical data, which comes from all sorts of
treatment carried out by Kernberg and others. They claim that his
material is presented without discussion of the contamination or
influence by the differing forms of psychotherapy or psychoanalysis
from which the data emerged, nor does the material refer to the stage

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36

of treatment (beginning, middle, or advanced) that may affect the


material. Calef and Weinshel also criticize his difficult terminology;
some of the terms Kernberg uses, they say, are defined and employed
in an idiosyncratic sense. They question whether one single entity
such as the borderline personality organization can be delineated in
this precise systematization. They argue also that there are too many
entities and pigeon holes resulting in mental acrobatics.
As do other authors (Abend et al. 1983), they challenge the
assumption that the interpretation of predominant primitive defensive
operations such as the projection of all-bad self- and objectrepresentations onto the therapist will strengthen the ego in these
extremely disturbed patients, and they raise the possibility that such
patients will actually be in danger of regression from such
interpretations. They believe that Kernberg continually shifts and
modifies his assertions so that he can maintain the discreteness of his
concept of borderline personality organization. They question how,
with all this tendency towards projection and projective identification
going on, the borderline patient can maintain reality testing inside or
outside of the therapy situation. They conclude that object-relations
theory is not reconcilable with Freuds tripartite structural theory,

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37

which they also insist is explicitly replaced by the object-relations


theory of Kernberg. They warn us not to view the patient through a
prism of prefabricated ideas based on what is believed to be
contained within a given diagnostic labela regressive harkening
back to a sort of Kraepelinian taxonomy (p. 489).
Calef and Weinshel raise certain issues that have been repeatedly
suggested in criticism of the psychology of the self although that
system certainly is different than Kernbergs approach. They suggest
that as a curious social phenomenon we are now in the midst of a
flurry of such proposals of revisions of psychoanalytic theory. They
do not feel it is yet possible to submit a specific formula that
encompasses all the elements of such revisions, but they warn that
more often than not, however, they have enjoyed only a transient
significance and popularity (p. 487). They worry about the retreat
from the centrality of the Oedipus complex and the emphasis on the
vicissitudes of sexuality to the role of aggression and pregenital factors
in psychological life. They believe that there has not been sufficient
attention to whether the material at hand represents a defensive
regression or a developmental arrest and/or defect (p. 488).

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Klein and Tribich (1981) state that Kernberg removes Freuds


drive theory and introduces a new metapsychology of his own. The
key to understanding Freud is the notion of the person driven by the
need to release something from within. These authors argue that
Kernberg confuses the object for attachment with Freuds object for
discharge of the drives. They point out that splitting, for Freud, related
to the mechanisms of denial and disavowal, which Freud used
differently than Kernberg, and that Kernberg posits the need for
human objects rather than drives as the basic human motivation. They
feel that this view is closer to Bowlbys attachment than Kernberg
admits and that it places psychopathology more in the area of
interpersonal relations. They insist that Kernberg dodges and confuses
the issue of the origin of aggression, and changes the meaning of libido
and aggression from drives to affect states accumulating from
environmental experiences (also see Goldberg 1985).
Klein and Tribich accuse Kernberg of misusing Hartmanns terms
of fusion and neutralization and argue that his criticisms of other
object relations theorists are defective. They conclude that Kernbergs
attempt at rapprochement and harmonious resolution between the
contrasting and competing Freudian instinct theory and object-

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39

relations theory is theoretically unwarranted and leads only to


confusion, distortion and inconsistency in which Kernbergs
synthesis becomes Kernbergs theory (p. 27). Their view is supported
by the detailed study of Greenberg and Mitchell (1983).
A general body of psychoanalytic knowledge of the narcissistic
and borderline disorders, and a generally agreed-upon set of
psychoanalytic metapsychological formulations of psychopathology
does not exist. The psychology of the self does not represent some
kind of singular heresy, as some authors have implied, nor does it
constitute a cult or splinter group. The psychology of the self
constitutes one of a number of current differing approaches to clinical
phenomena, and provides some explanations of clinical material which
hitherto seemed obscure or intransigent to traditional interpretations.

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40

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